ABSTRACT
Wernicke encephalopathy (WE) is a seldom encountered yet significant neuropsychiatric ailment resulting from a deficiency in thiamine (vitamin B1). While commonly linked with chronic alcoholism or insufficient dietary intake, instances of WE following bariatric and metabolic surgeries, notably laparoscopic Roux-en-Y gastric bypass (RYGB), have been sporadically documented. This case study elucidates the condition of a male patient who, 3 months after undergoing RYGB to address severe obesity, displayed abrupt alterations in mental status, swiftly ameliorated by immediate administration of intravenous high-dose thiamine.
Subject(s)
Gastric Bypass , Obesity, Morbid , Thiamine , Wernicke Encephalopathy , Humans , Wernicke Encephalopathy/etiology , Gastric Bypass/adverse effects , Male , Obesity, Morbid/surgery , Thiamine/administration & dosage , Thiamine/therapeutic use , Thiamine Deficiency/etiology , Adult , Postoperative Complications , Vitamin B Complex/administration & dosage , Vitamin B Complex/therapeutic useABSTRACT
Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease. However, few studies have investigated brain changes associated with chronic inflammation. We hypothesized that chronic inflammation might be related to brain structural alterations in patients with AD. Objectives: To investigate the association between disease severity (Eczema Area and Severity Index [EASI]), proinflammatory cytokines, and differences in brain gray matter (GM) volume in patients with AD. Methods: Nineteen patients with AD and 19 age- and sex-matched healthy subjects were enrolled. All participants underwent clinical assessment and brain magnetic resonance imaging. Voxel-based morphometry was performed to analyze GM volume differences. Results: Patients with AD exhibited significantly decreased GM volume in many brain regions, such as bilateral precentral gyrus, right frontal pole, and right middle temporal gyrus (P < 0.001), compared with healthy subjects. Notably, in patients with AD, the GM volume in right middle temporal gyrus was negatively associated with both EASI score and proinflammatory cytokines (sIL-2R [soluble interleukin 2 receptor] and TNF-α receptor-1), whereas the GM volume in left precentral gyrus was negatively associated with both EASI score and proinflammatory cytokines (sIL-2R and CRP). Conclusion: Patients with AD demonstrated significant brain GM volume reduction in many brain regions, which is related to disease severity and proinflammatory cytokines.
ABSTRACT
BACKGROUND: Vitiligo is reportedly associated with several ocular abnormalities. However, the relationship between vitiligo and retinal detachment (RD) remains unclear. OBJECTIVES: To examine the risk of RD in patients with vitiligo. METHODS: A nationwide population-based cohort study was conducted using data from the Taiwan National Health Insurance Database from 2007 to 2018. A total of 21 132 patients with vitiligo were matched in a 1 : 4 ratio with people without vitiligo by age, sex and comorbidity propensity score. Cumulative incidence and Cox proportional hazard models were used to investigate the risk of RD in patients with vitiligo. Subgroup analysis was performed. RESULTS: The cohort with vitiligo had a significantly higher rate of RD than the cohort without vitiligo [adjusted hazard ratio (aHR) 1.44, 95% confidence interval (CI) 1.20-1.72; P < 0.001]. Patients with vitiligo who required treatments such as phototherapy, systemic corticosteroids or immunosuppressants exhibited an even greater risk of RD (aHR 1.57, 95% CI 1.16-2.14; P = 0.004). CONCLUSIONS: Our study revealed a 1.44-fold increased risk of RD in patients with vitiligo, with an even higher risk in patients receiving phototherapy, systemic corticosteroids or immunosuppressants. The risk remained consistently higher over a 10-year follow-up period.
Subject(s)
Retinal Detachment , Vitiligo , Humans , Vitiligo/epidemiology , Vitiligo/complications , Taiwan/epidemiology , Male , Female , Adult , Retinal Detachment/epidemiology , Retinal Detachment/etiology , Middle Aged , Incidence , Risk Factors , Young Adult , Proportional Hazards Models , Immunosuppressive Agents/therapeutic use , Immunosuppressive Agents/adverse effects , Phototherapy , Cohort Studies , Adolescent , Databases, Factual , Adrenal Cortex Hormones/therapeutic use , Adrenal Cortex Hormones/adverse effects , Aged , ChildABSTRACT
Since the outbreak of COVID-19, management of atopic dermatitis (AD) has been widely discussed. Key issues include the risk of COVID-19 infection and related outcomes in AD patients, the efficacy and safety of COVID-19 vaccination in AD populations, and management of AD in the COVID-19 pandemic. Recent studies have shown that patients with AD have a slightly increased risk of COVID-19 infection but are not associated with a worse outcome than the non-AD population. COVID-19 vaccination is generally effective and safe in patients with AD. However, temporary discontinuation of certain systemic immunomodulatory agents after vaccination is suggested. During the pandemic, continuation of all immunomodulating agents is suggested, but these agents should be paused when patients with AD are infected with COVID-19 until recovery. Further studies are warranted to investigate the long-term interaction between AD and COVID-19 to aid clinical decisions during the pandemic.
Subject(s)
COVID-19 , Dermatitis, Atopic , Humans , Dermatitis, Atopic/epidemiology , Dermatitis, Atopic/therapy , Pandemics/prevention & control , COVID-19 Vaccines , VaccinationABSTRACT
Dupilumab interferes with the signaling pathways of IL-4 and IL-13 and is effective in treating atopic dermatitis. Specific genodermatoses, including Netherton syndrome, epidermolysis bullosa pruriginosa, and hyper-IgE syndrome, are Th2 skewed diseases with activation of type 2 inflammation. We performed this systematic review to investigate the therapeutic role of dupilumab in the treatment of genodermatosis. A systematic search was conducted of the PubMed, Embase, Web of Science, and Cochrane databases from inception to December 13, 2021. The review included studies with relevant terms including "dupilumab," "genodermatosis", "Netherton syndrome", "ichthyosis", "epidermolysis bullosa" and "hyper-IgE syndrome". The initial search yielded 2,888 results, of which 28 studies and 37 patients with genodermatosis were enrolled. The assessed genodermatoses included Netherton syndrome, epidermolysis bullosa pruriginosa, hyper-IgE syndrome, Hailey-Hailey disease, and severe eczema associated with genetic disorders. Most of the reported cases showed significant clinical improvement after the initiation of dupilumab treatment without major adverse events. Decreased immunoglobulin E levels and cytokine normalization have also been documented. In conclusion, Dupilumab may have a potential therapeutic role in certain genodermatoses skewed towards T helper 2 (Th2) immunity, including Netherton syndrome, epidermolysis bullosa pruriginosa, hyper-IgE syndrome, Hailey-Hailey disease, and severe eczema associated with some genetic disorders.
Subject(s)
Eczema , Pemphigus, Benign Familial , Humans , Immunoglobulin EABSTRACT
The merging of environmental maps constructed by individual UAVs alone and the sharing of information are key to improving the efficiency of distributed multi-UAVexploration. This paper investigates the raster map-merging problem in the absence of a common reference coordinate system and the relative position information of UAVs, and proposes a raster map-merging method with a directed crossover multidimensional perturbation variational genetic algorithm (DCPGA). The algorithm uses an optimization function reflecting the degree of dissimilarity between the overlapping regions of two raster maps as the fitness function, with each possible rotation translation transformation corresponding to a chromosome, and the binary encoding of the coordinates as the gene string. The experimental results show that the algorithm could converge quickly and had a strong global search capability to search for the optimal overlap area of the two raster maps, thus achieving map merging.
Subject(s)
AlgorithmsABSTRACT
A school-aged girl presented to the dermatology clinic with a 6-year history of hair loss and short hair, and light microscopy of scalp hair shafts revealed no structural abnormalities, such as cuticular damage, twisting, bending, or miniaturization. What is your diagnosis?
Subject(s)
Alopecia , Hair Diseases , Child , Humans , Alopecia/diagnosis , Alopecia/etiology , Hair , Hair Diseases/diagnosisABSTRACT
This paper proposes a new control strategy to deal with three different types of uncertainties for a class of time-varying delay nonlinear systems. Quite different from related celebrated works, the considered systems allow the existence of parameter uncertainties in the output function and nonlinearities, dynamic uncertainties of the unmeasurable state, and continuous external disturbances, which invokes the motivation of the paper. The objective is to construct a continuous output feedback controller by utilizing a new restructured integral function and the double-domination method. The novelty control design is the capability of tackling zero-dynamic and unknown output function simultaneously, thereby guaranteeing the state convergence of the closed-loop system. Finally, the proposed scheme is applied to a practical example and a numerical one simultaneously to demonstrate the effectiveness and the superiority.
ABSTRACT
This article develops a new controller design approach to stabilize system states onto the equilibrium at an arbitrarily selected time instant irrespective of the initial system states and parameters. By the stabilization approach, the actual convergence time (not the bound of actual convergence time) is independent of the initial value of system states. This feature differentiates our proposed prescribed-instant stability from conventional fixed, predefined, and prescribed time stability. In this work, we propose the controller design method for the prescribed-instant stability of n -order integrator systems. The proposed control is bounded and can gradually go to zero at an arbitrarily selected time instant, at which the system states reach zero simultaneously. This special stability of the controlled system is analyzed by reduction to absurdity. In simulations, an example of comparison with frequently used prescribed-time control is presented to show the difference. Moreover, the proposed stabilization method is validated by a magnetic suspension system with matched disturbances.
ABSTRACT
Psoriatic disease is a chronic inflammatory disorder with skin and joint manifestations. Due to the persistent inflammatory state exhibited by patients with psoriasis, multiple systemic comorbidities occur more frequently in patients with psoriasis than in the general population, and the risk of cardiovascular (CV) diseases is significantly increased. As the pathophysiology of psoriatic disease is becoming better understood, the sharing of underlying pathogenic mechanisms between psoriatic and CV diseases is becoming increasingly apparent. Consequently, careful attention to CV comorbidities that already exist or may potentially develop is needed in the management of patients with psoriasis, particularly in the screening and primary prevention of CV disease and in treatment selection due to potential drug-drug and drug-disease interactions. Furthermore, as the use of effective biologic therapy and more aggressive oral systemic treatment for psoriatic disease is increasing, consideration of the potential positive and negative effects of oral and biologic treatment on CV disease is warranted. To improve outcomes and quality of care for patients with psoriasis, the Taiwanese Dermatological Association, the Taiwanese Association for Psoriasis and Skin Immunology, and the Taiwan Society of Cardiology established a Task Force of 20 clinicians from the fields of dermatology, cardiology, and rheumatology to jointly develop consensus expert recommendations for the management of patients with psoriatic disease with attention to CV comorbidities.
Subject(s)
Arthritis, Psoriatic , Cardiology , Cardiovascular Diseases , Psoriasis , Humans , Arthritis, Psoriatic/drug therapy , Taiwan/epidemiology , Consensus , Psoriasis/therapy , Psoriasis/drug therapy , Cardiovascular Diseases/epidemiologyABSTRACT
This article is concerned with the global fast finite-time adaptive stabilization for a class of high-order uncertain nonlinear systems in the presence of serious nonlinearities and constraint communications. By renovating the technique of continuous feedback domination to the construction of a serial of integral functions with nested sign functions, this article first proposes a new event-triggered strategy consisting of a sharp triggered rule and a time-varying threshold. The strategy guarantees the existence of the solutions of the closed-loop systems and the fast finite-time convergence of original system states while reaching a compromise between the magnitude of the control and the trigger interval. Quite different from traditional methods, a simple logic is presented to avoid searching all the possible lower bounds of trigger intervals. An example of the maglev system and a numerical example are provided to demonstrate the effectiveness and superiority of the proposed strategy.
ABSTRACT
Diabetic wounds exhibit chronic inflammation and delayed tissue proliferation or remodeling, mainly owing to prolonged proinflammatory (M1) macrophage activity and defects in transition to prohealing/proremodeling (M2a/M2c; CD206+ and/or CD163+) macrophages. We found that topical treatment with ON101, a plant-based potential therapeutic for diabetic foot ulcers, increased M2c-like (CD163+ and CD206+) cells and suppressed M1-like cells, altering the inflammatory gene profile in a diabetic mouse model compared with that in the controls. An in vitro macrophage-polarizing model revealed that ON101 directly suppressed CD80+ and CD86+ M1-macrophage polarization and M1-associated proinflammatory cytokines at both protein and transcriptional levels. Notably, conditioned medium collected from ON101-treated M1 macrophages reversed the M1-conditioned mediumâmediated suppression of CD206+ macrophages. Furthermore, conditioned medium from ON101-treated adipocyte progenitor cells significantly promoted CD206+ and CD163+ macrophages but strongly inhibited M1-like cells. ON101 treatment also stimulated the expression of GCSF and CXCL3 genes in human adipocyte progenitor cells. Interestingly, treatment with recombinant GCSF protein enhanced both CD206+ and CD163+ M2 markers, whereas CXCL3 treatment only stimulated CD163+ M2 macrophages. Depletion of cutaneous M2 macrophages inhibited ON101-induced diabetic wound healing. Thus, ON101 directly suppressed M1 macrophages and facilitated the GCSF- and CXCL3-mediated transition from M1 to M2 macrophages, lowering inflammation and leading to faster diabetic wound healing.
Subject(s)
Cosmetic Techniques , Dermal Fillers , Skin Aging , Double-Blind Method , Humans , Hyaluronic Acid , Nasolabial Fold , Prospective Studies , Treatment OutcomeABSTRACT
Chronic exposure to solar ultraviolet (UV) light induces photoaging in human skin. Our previous results have shown that areca nut procyanidins (ANPs) have antioxidant capacity and possess potential anti-inflammatory effects. Here, we aimed to investigate the effect of ANPs on UVB-induced photoaging. In the present study, dorsal skin of CD-1 mice was exposed to UVB at a minimal erythema dose (130 mJ/cm2) throughout a 3-week period. The effects of ANPs and epigallocatechin-3-gallate (EGCG), a polyphenolic constituent of green tea, on UVB-induced photoaging were compared. The results show that oral administration of ANP prevented UVB-induced photoaging, indicated by epidermal thickness and collagen disorientation, and inhibited UVB-induced expression of cyclooxygenase-2 and matrix metalloproteinases (MMPs), such as MMP-2, MMP-9, and TIMP1. The protective potential of ANP on UVB-induced photodamage was comparable to that of EGCG. These data suggest that ANP could be useful as a dietary supplement to attenuate solar UVB-induced premature skin aging.
Subject(s)
Proanthocyanidins , Skin Aging , Animals , Areca , Cyclooxygenase 2 , Matrix Metalloproteinases , Mice , Mice, Hairless , Nuts , Proanthocyanidins/pharmacology , Skin , Ultraviolet Rays/adverse effectsABSTRACT
In this paper, an incorporated bridge-type superconducting fault current limiter (BSFCL) and Dynamic Voltage Restorer (DVR) is presented to improve the voltage quality and limiting fault current problems in distribution systems. In order to achieve these capabilities, the BSFCL and DVR are integrated through a common DC link as a BSFCL-DVR system. The FCL and DVR ports of the BSFCL-DVR system are located in the beginning and end of the sensitive loads' feeder integrated to the point of common coupling (PCC) in the distribution system. At first, the principle operation of the BSFCL-DVR is discussed. Then, a control system for the BSFCL-DVR system is designed to enhance the voltage quality and limit the fault current. Eventually, the efficiency of the BSFCL-DVR system is verified through the PSCAD/EMTDC simulation.